Benzodiazepines

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In the time since they were introduced, a growing body of evidence suggests that benzodiazepines have serious side effects. Some patients taking a benzodiazepine have experienced periods of irritability, rage, or outright aggression (Doweiko, 2015). Further, the duration of action of some benzodiazepines such as alprazolam is so short that there is a danger that the patient will start the benzodiazepine withdrawal syndrome before he or she is scheduled to take the next dose. Since anxiety is one of the cardinal symptoms of the withdrawal, the anxiety that the person experiences when in a state of withdrawal from a short-acting benzodiazepine is resolved with the next dose. This reaction raises the question of whether the patient is experiencing real anxiety, which certainly should be treated, or withdrawal-related anxiety. • What is happening physiologically when a benzodiazepine reduces anxiety? • How might a doctor assess whether a patient is experiencing actual anxiety or withdrawal symptoms when he or she complains of anxiety, and requests a new prescription? • What is the meaning of the term “neuroadaptation” and why do you think the term has become controversial as it relates to this discussion?